When you commit to the nursing profession, you’re not just committing yourself to caring for others, you’re committing yourself to doing so within a specific area of nursing. Just like you chose to study nursing in school instead of the many other options out there, you must also choose what kind of nurse you want to be.
This decision isn’t necessarily an easy one, but it’s also not an irreversible decision either. In the same way you can change your college major, you can similarly change your nursing specialty. That said, when deciding on an initial specialty, you need to think carefully about it.
There is a lot that goes into choosing a nursing specialty: education requirements, career advancement, responsibilities, salary, work setting, patient population, and even the most common diagnoses you’ll see on a daily basis.
With so much to consider, where do you begin?
Let’s start with the what.
Put simply, nursing specialties represent specific areas of nursing expertise. As you know by now the human body, how it works, and all the external factors that affect it are complex. Despite all you'll learn in nursing school and must know for the NCLEX, everything about every area of healthcare and in professional practice is simply too large a task for anyone.
Accordingly, just as in medicine there are different specialties that doctors will commit to, so too must nurses choose an area to specialize in. Nursing specialties can vary by patient age or demographic, type of care given, location of care given, and numerous other factors.
Some nurses even choose to work as travel nurses, gaining a variety of experience across these factors within a specialty (here is some data we collected on choosing a travel nurse specialty).
Some common specialties you’ve definitely heard of? Intensive Care Unit Nurse (ICU) or Emergency Department Nurse (ED/ER). These specialties are typically held by Registered Nurses or RNs, while some other common specialties are actually held by Advanced Practice Nurse Practitioners; for example, Family Nurse Practitioner, Pediatric Nurse Practitioner, or Psychiatric Nurse Practitioner.
Short answer? Licensed Practical Nurses/Licensed Vocational Nurses (LPN/LVNs), Registered Nurses (RNs), Advanced Practice Registered Nurses (APRNs), and Doctors of Nursing Practice (DNPs)… really all nurses! As mentioned above, the types of specialties available to you differ based upon your nursing school experience and education level. While there are dozens of nursing specialties that begin with RN requirements, there are plenty of others that require advanced degrees, either Masters Degrees in Nursing or even Doctorate Degrees in Nursing (DNPs or PhDs).
Accordingly, there are additional nurse practitioner specialties that are only available to nurses who’ve achieved a certain level of education.
We all know that education can be expensive, not to mention it can take away significant time from work. So, why commit to choosing a specialty, particularly one that requires further education? There are many reasons.
A big factor here is that in order to get a job you have to go work within a certain specialty or specialty group. Another is to align your professional work and what you do with what you're most interested in and passionate about! However, if your driver is not to pursue a particular medical interest (mental health, for example), it might be to support a specific demographic (which can greatly affect the type of patient care you give); if it’s not that, it might be to have more job opportunities (more specialized roles are often in higher demand) or even receive a higher salary.
There are plenty of reasons to pursue a specialty, but your reason (or reasons) will be just that, your own reasoning for choosing what path you want to follow. No one can answer that question for you, it simply takes time and a lot of thought.
When choosing a specialty halfway through nursing school, closer to graduation, or even part way through your career, the question most likely at the top of your mind is “Which specialty?” or “What do I want to do?” So, how do you decide which nursing specialty is right for you?
Unfortunately, answering this question cannot be distilled by taking a nursing specialty quiz or googling “highest paid nursing specialties.” It takes a lot of research, first-hand experience, weighing pros and cons, and, of course, introspection!
In the following resources, we’ll take a look at numerous specialty resources to help you decide which one is the best fit for you. We’ll cover in depth the various components of nursing specialties to keep in mind as you browse your options.
Do the patient population, care setting, delivery model, and diagnoses found within this specialty interest you, is it something you want to learn more about?
Do you have the educational requirement necessary to work in a given role within this specialty? If not, are they attainable for you, and would you be interested in pursuing them? (While some hospitals require a BSN vs. an ADN, having one or the other wouldn't generally preclude you from working within a certain specialty, more so at a certain facility.)
Is there a clear career pathway within the specialty? Do you have interest in pursuing additional certifications and experience within this specialty? Does the experience align with your career goals?
Do you have the certifications required for this specialty? Are you committed to completing them and keeping them up to date?
Does the salary feel fair for the work? Will the salary support your lifestyle or cost of living? Family needs, etc?
Are you interested in the procedures, types of patient interactions, makeup of the interdisciplinary team you'd be a part of, and the tools and technologies you'd be using (or lack thereof)?
Are you interested in seeing, discussing, and treating the most common diagnoses in this specialty?
Do you want to work in hospitals? Outpatient clinics? Emergency transport? (Where you’re working can be just as important as what you’re doing!) Do you think you would thrive in a fast-paced setting seeing a multitude of patients in a day, like the ER? Or would you rather build relationships with the same patients in the inpatient setting?
Have you weighed the pros and cons of the specialty? Have you done your research and spoken to other nurses with experience in this specialty? (No specialty is perfect, but one might be better for you than another.)
Cardiac care nurses care for patients who have cardiac conditions such as CHF, coronary artery disease, and cardiac arrhythmias.
A Certified Nurse Midwife (CNM) is an advanced practice nurse who cares for women during pregnancy, childbirth, and during their postpartum period.
Clinical nurse educators provide on-going instruction in areas that improve the quality of care provided by staff and other caregivers.
Critical care nurses (CCNs) care for patients with complex, life-threatening conditions in a variety of critical care settings.
An Emergency Department Nurse (ED), or Emergency Room Nurse (ER), is responsible for assessing, triaging, and treating patients that come through the hospital doors every day; this could entail treating injury, trauma, or acute-onset symptoms.
Home health nurses provide care to patients in their homes who need on-going support with their medical conditions.
Hospice nurses work with terminally ill or near end of life patients (hospice patients) and their families. Hospice care provides 24/7 supportive care for those with six months or less to live.
Neonatal intensive care (NICU) nurses care for infants who are premature (born prior to 32 weeks) or have critical conditions requiring high level constant monitoring.
Nurse advocates assist patients in understanding and making informed choices about the care they receive from physicians, health providers, and health facilities.
Nurse Anesthetists (CRNAs) are advanced practice nurses trained to administer anesthesia to patients undergoing surgery or other procedures.
Nurse practitioners (NPs) are advanced practice nurses who can deliver primary or acute care to different patient populations.
Women often first encounter OB nurses at their OB/GYN practitioner's office, where OB nurses help educate patients on sexual health, birth control, and assist with pelvic exams.
Oncology nurses have the challenging role of delivering care to cancer patients of all ages.
Pediatric nurses, sometimes called peds nurses, care for children from birth to teenage years who have acute and chronic health conditions.
Psychiatric Nurse Practitioners, also called Psychiatric-Mental Health Nurse Practitioners (PMHNPs), are advanced practice nurses who can serve as primary care providers for the mental health community.